The purpose of the proposal is the integration of several biomedical divisions, within the Hospital for Special Surgery into a coordinated program for research, treatment and education, as these missions relate to chronic rheumatic disease. The ultimate goal of the program is improved management of arthritis through 1) acquisition of new knowledge concerning the etiology and pathogenesis of the rheumatic diseases, 2) development of new methods of rehabilitation of patients with chronic disability from musculoskeletal disease, 3) training of professional personnel whose skills in the study and management of arthritis can be amplified by their roles as educators, and 4) evaluation of the efficacy and cost effectiveness of current and newly evolving techniques of health care for patients with arthritis. Initial emphasis will be placed on the further development of an existing program to serve as a tertiary care center, where training and research components will be concentrated, but efforts will be made to innovate and evaluate techniques for extending the Center's treatment and education goals into the community. There is a record of accomplishment through past cooperative efforts of the component departments and divisions of the Hospital for Special Surgery. The experience gained from such collaborative activities will serve as the model for design and development of the Multipurpose Arthritis Center.